How Old is Acupuncture? absorbing the Neolithic Origins theory

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Although westerners often think of this traditional Chinese treatment modality as a "new" form of alternative medicine, acupuncture is so aged in China that its origins are unclear. Agreeing to Huangfu Mi (c. 215-282 Ad), author of The Systematic superior of Acupuncture and Moxibustion, needling therapy was first used while China's Bronze Age, over five thousand years ago. He attributes its invention to either Fu Xi or Huang Di (the Yellow Emperor), two legendary figures of the Five Emperors duration (c. 3000-2070 Bc). Modern scholars ordinarily believe that acupuncture is much older, originating more than ten thousand years ago while China's Neolithic Age (c. 8000-3500 Bc).

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How is How Old is Acupuncture? absorbing the Neolithic Origins theory

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In actuality, acupuncture may not be as aged as has ordinarily been assumed. A reconsideration of all extant documents and recent archaeological finds indicates that acupuncture may date back a mere 2100 to 2300 years, first appearing while China's Warring States duration (475-221 Bc) and rapidly maturing while the Western Han Dynasty (206 Bc-24 Ad).

Questioning the ordinarily appropriate origins theory.

The currently appropriate principles about the Neolithic origins of acupuncture is based on two premises. The first holds that bian shi, specialized sharp-edged stone tools that appeared while China's Neolithic Age, were used for an early form of needling therapy, prior to the invention of metal smelting. It is known that bian shi stone tools were utilized for a estimate of early curative procedures, beginning while the Neolithic Age and lasting through the Western Han Dynasty (206 Bc-24 Ad). A estimate of descriptions of bian shi stone therapy appear in one of China's earliest curative works, The Yellow Emperor's Inner superior of treatment (Huang Di Neijing, time to come referred to as the Neijing) (c. 104-32 Bc). It has been opinion that these Neolithic stone curative instruments were precursors of the metal acupuncture needles that came into use while China's Iron Age.

However, historical documents and new archaeological evidence clearly indicate that bian shi stone tools were flat and knife-like in form, used primarily to incise abscesses to dismissal pus, or to draw blood (1). They were applied as surgical scalpels to cut, rather than as needles to puncture, and had nothing to do with needling therapy. Agreeing to the Code of Hammurabi, the aged inhabitants of Mesopotamia used similarly shaped bronze knives to incise abscesses over 4000 years ago.

Prehistoric Chinese population possessed needles made of various materials, fluctuating from crude thorns and quills to bone, bamboo, pottery, and stone. But just as the history of the knife is not the history of surgery, so the invention of needles and that of acupuncture are two entirely different things. Needles have historically been among the most ordinarily used tools of daily life for constructing garments all over the world. Medically, needles are used to suture incisions just as production up clothes with darners, hollow syringe needles (as differentiated from a solid needle used in acupuncture) are applied to inject fluids into the body or draw them from it, but pricking a solid needle into the body to treat illness seems very strange and enigmatical. In English, "to give somebody the needle" means to displease or irritate someone. Most population prefer not to be punctured with needles, and associate needling with pain and injury. Many plants and animals have evolved thorns or quills as superior weapons for protection or attack. Needles were even used for punishment in aged China. By trial and error, healers throughout the world have found treatments for pain and other diseases independently, for instances, herbs, roots, wraps, rubs, blood-letting and surgery, but acupuncture alone is unique to Chinese. Inspecting the unique Chinese origin of acupuncture, it is uncostly to assume that the invention of acupuncture was not associated to the availability of either sewing needles or bian shi stone scalpels while China's Neolithic Age.

The second factory supporting the principles of the Neolithic origins of acupuncture holds that acupuncture evolved as a natural outgrowth of daily life in prehistoric times. It is opinion that through a process of fortuitous urgency and repeated empirical experience, it was discovered that needling various points on the body could effectively treat various conditions. However, this assumption is lacking in both basic historical evidence and a logical foundation.

It is known that aged population were aware of situations in which physical problems were relieved following unrelated injury. Such a case was reported by Zhang Zihe (c. 1156-1228 Ad), one of the four eminent physicians of the Jin and Yuan Dynasties (1115-1368 Ad) and a master in blood-letting therapy: "Bachelor Zhao Zhongwen advanced an acute eye problem while his participation in the imperial examination. His eyes became red and swollen, accompanied by blurred foresight and severe pain. The pain was so unbearable that he contemplated death. One day, Zhao was in teahouse with a friend. Suddenly, a stovepipe fell and hit him on the forehead, causing a wound about 3-4 cun in length and letting copious amounts of dark purple blood. When the bleeding stopped, a miracle had occurred. Zhao's eyes stopped hurting; he could see the road and was able to go home by himself. The next day he could make out the ridge of his roof. Within some days, he was completely recovered. This case was cured with no intentional treatment but only accidental trauma (2)."

If acupuncture did, in fact, gently build as the effect of such fortuitous accidents, China's four thousand years of recorded history should comprise numerous similar accounts about the discovery of the acupoints and their properties. But my uncut hunt of the massive Chinese curative canon and other literature has yielded only this single case. Actually, this story offers at most an example of blood-letting therapy, which differs in some principal regards from acupuncture. The point of blood-letting therapy is to take off a inescapable estimate of blood. But when puncturing the body with solid needles, nothing is added to or subtracted from the body.

Blood-letting therapy is universal. Throughout recorded history, population nearby the world have had similar experiences with the beneficial results of accidental injury, and have advanced curative methods based on the principle that injuring and inducing bleeding in one part of the body can relax problems in an additional one area. The aged Greeks and Romans advanced venesection and cupping based on the discovery that bleeding is beneficial in cases such as fever, headache, and disordered menstruation. Europeans while the Middle Ages used blood-letting as a panacea for the stoppage and treatment of disease. Detailed directions were given about the most convenient days and hours for blood-letting, the correct veins to be tapped, the estimate of blood to be taken, and the estimate of bleedings. Blood was usually taken by occasion a vein with a lancet, but sometimes by blood-sucking leeches or with the use of cupping vessels. Blood-letting using leeches is still practiced in some areas of Europe and the Middle East. However, nowhere did these blood-letting methods build into a detailed and uncut principles comparable to that of acupuncture. If acupuncture did for real arise from repeated empirical palpate of accidental injury, it should have advanced all over the world, rather than just in China.

Both historical evidence and logic indicate that there is no causal relation in the middle of the improvement of materials and techniques for production needles and the invention of acupuncture. It is also clear that repeated palpate of fortuitous accidental injury was not a traditional factor in the improvement of acupuncture. Therefore, the ordinarily appropriate principles about the Neolithic origins of acupuncture, based as it is upon such faulty premises, must be incorrect. It is now principal to reconsider when acupuncture did, in fact, first appear and subsequently mature.

Reconsidering the evidence

If acupuncture did for real generate while China's Neolithic Age, references to it should appear throughout China's earliest written records and archaeological relics. However, this is not the case.

Early cultures believed the world to be filled with the supernatural, and advanced various methods of divination. while China's Shang Dynasty (c. 1500-1000 Bc), divination was practiced by burning animal bones and tortoise shells with moxa or other materials. Oracular pronouncements were then inscribed on the bone or shell, based on the resulting crackles. These inscriptions have survived as the earliest examples of written Chinese characters. Among the hundreds of thousands of inscribed oracle bones and shells found to date, 323 comprise predictions about over twenty different diseases and disorders. However, none of these inscriptions mention acupuncture, or any other form of treatment for that matter.

Rites of the Zhou Dynasty (Zhou Li), written while the Warring States duration (475-221 Bc), records in information the legal rituals and regulations of the Zhou Dynasty (c. 1000-256 Bc), including those about medicine. Royal doctors at that time were divided into four categories: dieticians, who were responsible for the rulers' food and drink; doctors of internal medicine, who treated diseases and disorders with grains and herbs; surgeons, or yang yi, who treated problems such as abscesses, open sores, wounds, and fractures using zhuyou (incantation), medication, and debridement (using stone or metal knives to scrape and take off pus and necrotic tissue); and veterinarians, who treated animals. But this document as well contains no references to acupuncture.

Neijing (c. 104-32 Bc) is the first known work about acupuncture. The superior consists of two parts: Suwen - simple Questions, and Lingshu - the Spiritual Pivot, also known as The superior of Acupuncture (Zhen Jing). Both are involved primarily with the principles and custom of acupuncture and moxibustion. Although authorship of the Neijing is attributed to Huang Di, the legendary Yellow Emperor (c. 2650 Bc), most scholars reconsider that this master work, which contains excerpts from more than twenty pre-existing curative treatises, was for real compiled in the middle of 104 Bc and 32 Bc, while the latter part of the Western Han dynasty (206 Bc-24 Ad). The uncut and very advanced nature of the curative principles presented in the Neijing has led scholars to believe that needling therapy has an very long history, probably reaching back to prehistoric times. The traditional versions of the aged texts used in the compilation of the Neijing have been lost, and with them the occasion to additional illuminate the demand of when acupuncture for real first appeared. However, expected new archaeological evidence, unearthed in China in the early 1970s and 1980s, reveals the true state of Chinese treatment prior to the Neijing, and challenges existing assumptions about the Neolithic origins of acupuncture.

In late 1973, fourteen curative documents, known as the aged curative Relics of Mawangdui, were excavated from Grave No. 3 at Mawangdui, Changsha, Hunan Province. Ten of the documents were hand-copied on silk, and four were written on bamboo slips. The exact age of the aged curative Relics of Mawangdui has not been determined. However, a wooden tablet found in the grave states that the deceased was the son of Prime clergyman Li Chang of the state of Changsha, and that he was buried on February 24, 168 Bc. The unsystematic and empirical nature of the material contained in the documents indicates that they were written well before their interment in 168 Bc, probably nearby the middle of the Warring States duration (475-221 Bc). In any event, it is inescapable that these curative documents pre-date the Neijing (compiled c. 104-32 Bc), production them the oldest known curative documents in existence. These documents were probably lost sometime while the Eastern Han Dynasty (25-220 Ad), since no mention of them has been found from this time until their rediscovery in 1973.

Another principal curative find, The Book of the Meridians (Mai Shu), was excavated from two aged tombs at Zhangjiashan in Jiangling County, Hubei Province in 1983. These aged texts, written on bamboo slips and quite well preserved, were probably buried in the middle of 187 and 179 Bc, nearby the same time as the Mawangdui relics. There are five documents in all, three of which (The superior of Moxibustion with Eleven Yin-Yang Meridians, Methods of Pulse exam and Bian Stone, and Indications of Death on the Yin-Yang Meridians) are selfsame to the texts found at Mawangdui.

There is abundant evidence to show that the authors of the Neijing used the earlier curative texts from Mawangdui and Zhangjiashan as traditional references, additional indicating the antiquity of these relics. For example, episode 10 of the Lingshu section of the Neijing contains a discussion of the meridians and their disorders that is very similar, in both form and content, to that found in the superior of Moxibustion with Eleven Yin-Yang Meridians, one of the documents found at both Mawangdui and Zhangjiashan.

Of course, the Neijing did not naturally reproduce these earlier documents, but rather refined and advanced them, and introduced new therapeutic methods. The earlier superior of Moxibustion with Eleven Yin-Yang Meridians is small to moxibustion, while episode 10 of the Lingshu section of the Neijing mentions needling therapy, or acupuncture, for the first time. Although the curative texts preceding the Neijing discuss a wide variety of curative techniques, including herbal medicine, moxibustion, fomentation, restorative bathing, bian stone therapy, massage, daoyin (physical exercises), xingqi (breathing exercises), zhuyou (incantation), and even surgery, these earlier documents comprise no mention of acupuncture.

If needling therapy did for real generate much earlier than the Neijing (c. 104-32 Bc), the curative documents unearthed from Mawangdui and Zhangjiashan, very probably used as traditional references by the Neijing's authors, should also comprise uncut discussions of acupuncture. However, they do not. This clearly indicates that acupuncture was not yet in use at the time that the Mawangdui and Zhangjiashan documents were compiled. Of course, it is not inherent to draw a detailed picture of the state of acupuncture early in the Western Han Dynasty (206 Bc-24 Ad) based solely on the curative relics from Mawangdui and Zhangjiashan. But the fact that these documents were determined principal sufficient to be buried with the deceased indicates that they do reflect general curative custom at the time.

The Historical Records (Shi Ji) (c. 104-91 Bc) by Sima Qian contains evidence that acupuncture was first used roughly one hundred years prior to the compilation of the Neijing (c. 104-32 Bc). The Historical Records, China's first uncut history, consists of a series of biographies reaching from the time of the legendary Yellow Emperor (c. 2650 Bc) to Emperor Wudi (156-87 Bc) of the Western Han Dynasty. Among these are biographies of China's two earliest curative practitioners, Bian Que and Cang Gong. Bian Que's given name was Qin Yueren. It is known that he lived from 407-310 Bc, while the late Warring States duration (475-221 Bc), and was a Modern of Hippocrates (c. 460-377 Bc), the father of Western medicine. Bian Que's life was surrounded by an aura of difficulty which makes it difficult to cut off fact from legend. His name means Wayfaring Magpie - a bird which symbolizes good fortune. It is said that an old man gave Bian Que a estimate of esoteric curative texts and an herbal prescription, and then disappeared. Bian Que took the treatment Agreeing to the mysterious visitor's instructions. Thirty days later, he could see through walls. Thereafter, whenever he diagnosed disease, he could clearly see the internal organs of his patients' bodies. Like the centaur Chiron, son of Apollo, who is sometimes regarded as the god of surgical operation in the West, Bian Que is determined to be a supernatural figure, and the god of healing. A stone relief, unearthed from a tomb dating back to the Han Dynasty (206 Bc-220 Ad), depicts him with a human head on a bird's body (3). The Historical Records states that Bian Que successfully resuscitated the prince of the State of Guo using a combination of acupuncture, fomentation, and herbal medicine. Bian Que is thus determined to be the founder of acupuncture, and to have made the first recorded use of acupuncture while the Warring States duration (475-221 Bc).

More solid evidence connects the birth of acupuncture with the notable aged physician Chunyu Yi (c. 215-140 Bc), popularly known as Cang Gong. Cang Gong's life and work are described in information in the Historical Records. The Historical Records state that in 180 Bc, Cang Gong's educator gave him a estimate of costly curative texts that had escaped the book-burnings of the last days of the Great Qin Empire (221-207 Bc). At that time, adherents of all opposing schools of opinion were executed or exiled, and roughly all books not conforming to the rigid Legalist doctrines that dominated the Qin Dynasty were burned. Although curative texts escaped the disaster, their owners still feared persecution. The banned books that Cang Gong received might have included a estimate whose titles appear in the aged curative Relics of Mawangdui, such as the superior of Moxibustion with Eleven Yin-Yang Meridians, superior of Moxibustion with Eleven Foot-Arm Meridians, recipe of Pulse exam and Bian Stone, Therapeutic Methods for 52 Diseases, Miscellaneous Forbidden Methods, and The Book of Sex.

Cang Gong's biography in the Historical Records discusses twenty-five of his cases, dating from roughly 186 Bc to 154 Bc. These cases studies, the earliest in recorded Chinese history, give a clear picture of how disease was treated over 2100 years ago. Of the twenty-five cases, ten were diagnosed as incurable and the patients died as predicted. Of the fifteen that were cured, eleven were treated with herbal medicine, two with moxibustion in combination with herbal medicine, one with needling, and one with needling in combination with pouring cold water on the patient's head. It can be seen from this material that Cang Gong used herbal treatment as his traditional treatment, and acupuncture and moxibustion only secondarily. His use of moxibustion adheres strictly to the doctrines recorded in the medial relics from Mawangdui and Zhangjiashan. Although only two of Cang Gong's moxibustion cases are recorded in the Historical Records, it is known that he was master in its use, and that he wrote a book called Cang Gong's Moxibustion. Unfortunately, this book has been lost. In comparison with his wide-ranging utilization of herbal treatment and moxibustion, Cang Gong applied needling therapy very sparingly. Neither of Cang Gong's two recorded acupuncture cases mentions specific acupoints or how the needles were manipulated, indicating that needling therapy at the time was still in its first stage.

Although acupuncture was not in tasteless use while Cang Gong's day, his two recorded acupuncture patients were cured with only one treatment, indicating the efficacy of the nascent therapy. The rapid improvement of acupuncture was soon to follow. By the time the Neijing was compiled (c. 104-32 Bc), roughly one hundred years after the time of Cang Gong, acupuncture had substituted herbs and moxibustion as the treatment of choice. Only thirteen herbal prescriptions are recorded in the Neijing, compared with hundreds utilizing acupuncture.

Archaeological excavations of Western Han Dynasty (206 Bc-24 Ad) tombs have yielded a estimate of leading curative relics associated to acupuncture, in increasing to the Neijing and Historical Records. In July of 1968, nine metal needles were excavated at Mancheng, Hebei Province from the tomb of Prince Liu Sheng (?-113 Bc) of Zhongshan, elder brother of Emperor Wu Di (156-87 Bc) of the Western Han Dynasty (206 Bc-24 Ad). Four of the needles are gold and quite well preserved, while five are silver and decayed to the extent that it was not inherent to restore them completely. The estimate and shapes of the excavated needles indicate that they may have been an exhibit of the nine types of acupuncture needles described in the Neijing. This possibility is supported by the fact that a estimate of additional curative instruments were found in the tomb. These included a bronze yigong (practitioner's basin) used for decocting restorative herbs or production pills, a bronze sieve used to filter herbal decoctions, and a silver utensil used to pour treatment (4). Although many prehistoric bone needles have been unearthed, the fact that they have eyes indicates that they were used for sewing. Some scholars have inferred that prehistoric Chinese population may have used bone needles found with no eyes or with points on both ends for curative purposes. However, I believe that it is rash to draw such a end based solely on relics that have lain buried for thousands of years. Rather, it is likely that the eyes of these needles have naturally decayed over the millennia.

Conclusion

A appropriate reevaluation of all extant literature, as well as documents and archaeological relics unearthed since the 1960s, confirms that acupuncture is not as aged as has ordinarily been assumed, and that it did not, in fact, appear and gently build while China's Neolithic Age (c. 8000-3500 Bc). Rather, this great invention arose quite suddenly and rapidly advanced roughly two millennia ago. All evidence indicates that acupuncture first appeared while the Warring States duration (475-221 Bc), while the time of Bian Que, advanced while the early Western Han Dynasty (206 Bc-24 Ad), while the time of Cang Gong, and had fully matured by the latter part of the Western Han Dynasty, at the time of the compilation of the Neijing (c. 104-32 Bc).

The Western Han Dynasty (206 Bc-24 Ad) provided fertile ground for the rapid growth and maturation of acupuncture as a uncut curative system. The previous centuries had seen the blossoming of Chinese culture while the intellectual give-and-take of the Spring and Autumn (770-476 Bc) and Warring States (475-221 Bc) periods. The subsequent territorial unification of China by the Qin Dynasty (221-207 Bc) laid a foundation for the cultural integration of the diverse states. Taken in the context of China's four thousand years of recorded history, the Western Han Dynasty was a duration of oppressive communal and cultural advancement. Acupuncture is unique. Its invention of acupuncture in China at this time was the effect of the improvement and unique convergence of some aspects of Chinese culture while this time, including natural science, communal structure and human relations, and most importantly, holistic philosophy.

References and notes:
1. Bai Xinghua, et al., Acupuncture: visible Holism. Oxford: Butterworth-Heinemann, 2001, pps. 15-20.

2. Zhang Zhihe (1156-1228 Ad), Confucians' Duties to Their Parents (Rumen Shiqin). Quoted in selection and commentary of curative Cases Treated by Past Dynasties' Eminent Acupuncturists (Lidai Zhenjiu Mingjia Yian Xuanzhu), ed. Li Fufeng. Harbin: Heilongjiang Science and Technology Publishing House, 1985, p. 143.

3. Liu Dunyuan. Stone Relief Showing custom of Acupuncture and Moxibustion from the Eastern Han Dynast. Archaeology, 1972; (6): 47-51

4. Zhong Yiyan, curative Instruments Unearthed from the Western Han Dynasty Tomb of Liu Sheng. Archaeology, 1972, (3): pp. 49-53.

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